Abstract
We conducted the present multicenter, retrospective study to assess the epidemiological, clinical, laboratory, and radiological characteristics associated with critical illness among patients with COVID-19 from Egypt. The present study was a multicenter, retrospective study that retrieved the data of all Egyptian cases with confirmed COVID-19 admitted to hospitals affiliated to the General Organization for Teaching Hospitals and Institutes (GOTHI) through the period from March to July 2020. The diagnosis of COVID-19 was based on a positive reverse transcription-polymerase chain reaction (RT-PCR) laboratory test. This retrospective study included 2724 COVID-19 patients, of whom 423 (15.52%) were critically ill. Approximately 45.86% of the critical group aged above 60 years, compared to 39.59% in the non-critical group (p = 0.016). Multivariate analysis showed that many factors were predictors of critically illness, including age >60 years (OR = 1.30, 95% CI [1.05, 1.61], p = 0.014), low oxygen saturation (OR = 0.93, 95% CI [0.91, 0.95], p<0.001), low Glasgow coma scale (OR = 0.75, 95% CI [0.67, 0.84], p<0.001), diabetes (OR = 1.62, 95% CI [1.26, 2.08], p<0.001), cancer (OR = 2.47, 95% CI [1.41, 4.35], p = 0.002), and serum ferritin (OR = 1.004, 95% CI [1.0003, 1.008], p = 0.031). In the present report, we demonstrated that many factors are associated with COVID-19 critical illness, including older age groups, fatigue, elevated temperature, increased pulse, lower oxygen saturation, the preexistence of diabetes, malignancies, cardiovascular disease, renal diseases, and pulmonary disease. Moreover, elevated serum levels of ALT, AST, and ferritin are associated with worse outcomes. Further studies are required to identify independent predictors of mortality for patients with COVID-19.
Highlights
Since the discovery of the initial cluster of cases in Wuhan, China, the coronavirus disease 2019 (COVID-19) outbreak has emerged as one the greatest health threat and was declared as a pandemic by the World Health Organization (WHO) on March 11, 2020 [1, 2]
We demonstrated that many factors are associated with COVID-19 critical illness, including older age groups, fatigue, elevated temperature, increased pulse, lower oxygen saturation, the preexistence of diabetes, malignancies, cardiovascular disease, renal diseases, and pulmonary disease
Elevated serum levels of ALT, AST, and ferritin are associated with worse outcomes
Summary
Since the discovery of the initial cluster of cases in Wuhan, China, the coronavirus disease 2019 (COVID-19) outbreak has emerged as one the greatest health threat and was declared as a pandemic by the World Health Organization (WHO) on March 11, 2020 [1, 2]. By the end of October 2020, the COVID-19 outbreak has affected more than 200 countries in various regions of the world; according to the WHO situation reports, the number of COVID-19 confirmed cases reached more than 41,571,000 cases and 1,135,000 related deaths worldwide [3]. In the past few months, the COVID-19 pandemic landscape has changed with a dramatic shift in the apex of the number of confirmed cases from China to the United States (US), Europe, and Eastern Mediterranean Region (EMR) [4, 5]. The current body of evidence demonstrates that the infection can be transmitted by both symptomatic and asymptomatic cases leading to the dramatic spread of the outbreak within the community [9]
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